The DOI matches its Crossref record; 43 of the 43 references it cites were found in a registry or an index.
Validation of the Hospital Anxiety and Depression Scale for use with multiple sclerosis patients
Abstract
Detecting clinically significant symptoms of depression and anxiety in medically ill patients using self-report rating scales presents a challenge because of somatic confounders. The Hospital Anxiety and Depression Scale (HADS) was developed with this in mind, but has never been validated for a multiple sclerosis population. Our objective was to validate the HADS for multiple sclerosis patients. Multiple sclerosis patients were interviewed for the presence of major depression (n = 180) and anxiety disorders (n = 140) with the Structured Clinical Interview for DSM-IV disorders. A receiver operating characteristic (ROC) analysis was undertaken to assess which HADS cut-off scores give the best yield with respect to diagnoses of major depression and all anxiety disorders defined by the Structured Clinical Interview for DSM-IV. A threshold score of 8 or greater on the HADS depression subscale provides a sensitivity of 90% and specificity of 87.3% (ROC area under the curve 0.938). The same cut-off score gives a sensitivity of 88.5% and a specificity of 80.7% on the anxiety subscale (ROC area under the curve 0.913), but for generalized anxiety disorder only. The study confirms the usefulness of the HADS as a marker of major depression and generalized anxiety disorder, but not other anxiety disorders, in multiple sclerosis patients.
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“A cut-off of >7 gives a high sensitivity and specificity for detecting clinically elevated depression and anxiety in pwMS (Honarmand & Feinstein, 2009).”
From Neuropsychology intervention for managing invisible symptoms of MS (NIMIS-MS) group: A pilot effectiveness and acceptability study (2024) · cites this paper as Honarmand & Feinstein, 2009
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Does depression in multiple sclerosis mediate effects of cognitive functioning on quality of life?
Crouch, T. A., Reas, H. E., Quach, C. M., & Erickson, T. M. (2021) · Quality of Life Research · doi:10.1007/s11136-021-02927-w · Cited by 13
Meek, C., das Nair, R., Evangelou, N., Middleton, R., Tuite-Dalton, K., & Moghaddam, N. (2022) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2022.104154 · Cited by 12
Pavisian, B., Patel, V., & Feinstein, A. (2019) · BMC Neurology · doi:10.1186/s12883-019-1543-8 · Cited by 11
Self-citationLooking anew at cognitive dysfunction in multiple sclerosis
Feinstein, A., Lapshin, H., & O'Connor, P. W. (2012) · Neurology · doi:10.1212/wnl.0b013e3182698da3 · Cited by 11
Self-citationMontanari, E., Rottoli, M., Maimone, D., Confalonieri, P. A., Plewnia, K., Frigo, M., Francia, A., Pala, A., Losignore, N. A., Ragonese, P., et al. (2016) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2016.02.047 · Cited by 11
“A HADS-A and HADS-D score of ≥8 indicates a high risk of anxiety and depressive disorder in MS patients [16].”
BackgroundShalmoni, N., & Kalron, A. (2020) · Journal of Neural Transmission · doi:10.1007/s00702-020-02190-2 · Cited by 11
Learmonth, Y. C., Kaur, I., Baynton, S. L., Fairchild, T. J., Paul, L., & van Rens, F. E. C. A. (2021) · Contemporary Clinical Trials · doi:10.1016/j.cct.2021.106281 · Cited by 11
Jennings, L. (2018) · Springer eBooks · doi:10.1007/978-3-319-74604-3_4 · Cited by 12
Jones, J., Walsh, S., & Isaac, C. L. (2014) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/s10880-014-9408-1 · Cited by 11
Hechenberger, S., Helmlinger, B., Penner, I., Pirpamer, L., Fruhwirth, V., Heschl, B., Ropele, S., Wurth, S., Damulina, A., Eppinger, S., et al. (2023) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2023.120833 · Cited by 10
“…” (HADS; maximum score for anxiety and depression: 21; cut-off scores for clinical relevant levels of depression/anxiety: ≥ 8; clinically significant depression/anxiety: ≥ 11) [18,19] and self-efficacy with the “ Skala zur Allgemeinen Selbstwirksamkeitserfahrung ” (SWE; maximum score: 40) [20].”
MethodA taxonomy of cognitive phenotypes in Multiple Sclerosis: a 1-year longitudinal study
Podda, J., Antonio, F. D., Tacchino, A., Pedullà, L., Grange, E., Battaglia, M. A., Brichetto, G., & Ponzio, M. (2024) · Scientific Reports · doi:10.1038/s41598-024-71374-7 · Cited by 10
Feinstein, A., Meza, C., Stefan, C., & Staines, W. R. (2021) · Brain and Behavior · doi:10.1002/brb3.2220 · Cited by 10
Self-citationPavisian, B., Staines, R. W., & Feinstein, A. (2015) · Multiple Sclerosis Journal - Experimental Translational and Clinical · doi:10.1177/2055217315588223 · Cited by 10
Self-citationComparing depression screening tools in persons with multiple sclerosis (MS).
Hanna, J., Santo, J. B., Blair, M., Smolewska, K., Warriner, E. M., & Morrow, S. A. (2016) · Rehabilitation Psychology · doi:10.1037/rep0000115 · Cited by 10
Contentti, E. C., López, P. A., Nadur, D., Balbuena, M. E., Finkelsteyn, A. M., & Tkachuk, V. A. (2018) · International Journal of MS Care · doi:10.7224/1537-2073.2018-009 · Cited by 10
Prada, V., Tacchino, A., Podda, J., Pedullà, L., Konrad, G., Battaglia, M. A., Brichetto, G., & Bragadin, M. M. (2021) · European Journal of Physical and Rehabilitation Medicine · doi:10.23736/s1973-9087.20.06446-1 · Cited by 10
Distractibility in multiple sclerosis: The role of depression
Patel, V., Zambrana, A., Walker, L. A. S., Herrmann, N., Swartz, R. H., & Feinstein, A. (2016) · Multiple Sclerosis Journal - Experimental Translational and Clinical · doi:10.1177/2055217316653150 · Cited by 10
“Our study supports previous research showing that depression adds to the cognitive burden in people with MS.”
MethodInfluentialSelf-citationSaul, A., Taylor, B., Simpson, S., Ponsonby, A.-L., Blizzard, L., Dwyer, T., McMorran, B., Wood, B., & van der Mei, I. A. (2019) · Multiple Sclerosis Journal · doi:10.1177/1352458518770021 · Cited by 9
“7% specificity when compared with the diagnosis of generalised anxiety disorders.(25)”
BackgroundFoley, P., Kong, Y., Dirvanskiene, R., valdes-Hernandez, M., Bastiani, M., Murnane, J., Sellar, R., Roberts, N., Pernet, C., Weir, C., et al. (2022) · Brain Communications · doi:10.1093/braincomms/fcac124 · Cited by 11
“In a post-hoc analysis, in order to illustrate clinical relevance of the data on depression and anxiety symptoms 27 presented, the number of participants in each group meeting thresholds for major depression and generalized anxiety disorder were calculated using a threshold of eight and above for both HADS-depression,…”
BackgroundMethodResultInfluentialDavenport, R. A., Bevens, W., Neate, S. L., Jelinek, P. L., Yu, M., Jelinek, G. A., & Reece, J. C. (2024) · Journal of Medical Internet Research · doi:10.2196/60240 · Cited by 10
“…in the population living with MS (eg, Dahl et al [21] and Janssens et al [22]), has demonstrated accurate sensitivity and specificity for major depressive disorder (90% and 87%, respectively) and generalized anxiety disorder (88% and 81%, respectively) within the population living with MS [23].”
Not for everyone: Factors influencing who receives psychotherapy in people with multiple sclerosis
Freedman, D., Oh, J., & Feinstein, A. (2024) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2024.106245 · Cited by 10
Self-citationGromisch, E. S., Raskin, S. A., Neto, L. O., Haselkorn, J. K., & Turner, A. P. (2023) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2023.104509 · Cited by 9
Neuropsychiatric Status of Patients With Multiple Sclerosis Across Disease Duration Intervals
Freedman, D., Oh, J., & Feinstein, A. (2023) · Journal of Neuropsychiatry · doi:10.1176/appi.neuropsych.20220124 · Cited by 15
Self-citationImpairment, disability and fatigue in multiple sclerosis.
Shahrbanian, S., Duquette, P., & Mayo, N. E. (2018) · Europe PMC (PubMed Central) · doi:10.22088/cjim.9.3.244 · Cited by 10
“04 Men 49(26) 15(8) 34(18) Education, N (%)”
MethodWalker, L. A. S., Gardner, C. M., Freedman, M. S., MacLean, H. J., Rush, C., & Bowman, M. (2018) · International Journal of MS Care · doi:10.7224/1537-2073.2017-090 · Cited by 9
Wilkie, D., Solari, A., & Nicholas, R. S. (2020) · Multiple Sclerosis Journal - Experimental Translational and Clinical · doi:10.1177/2055217320959802 · Cited by 9
Alharbi, N. A. N., Alawi, S., Alharbi, Y. M., Alharbi, M. Y., Alsamarh, T. N., Aldubaiyan, A. A. R., Alwasil, S., & Alomairi, A. A. (2022) · Neurosciences · doi:10.17712/nsj.2022.2.20210101 · Cited by 9
Sousa, C., Jacques, T., Sá, M. J., & Alves, R. A. (2022) · Applied Neuropsychology Adult · doi:10.1080/23279095.2022.2112681 · Cited by 11
“The HADS is widely used in clinical practice and has been validated in the MS population (Honarmand & Feinstein, 2009; Silva et al., 2011).”
BackgroundMethodA nurse-led mental health service for people with multiple sclerosis
Askey‐Jones, S., Silber, E., Shaw, P., Gray, R. J., & David, A. S. (2012) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2012.01.020 · Cited by 9
Psychometric evaluation of a Canadian version of the Seattle Angina Questionnaire (SAQ-CAN)
for the APPROACH Investigators, Lawal, O. A., Awosoga, O., Santana, M., James, M. T., Southern, D. A., Wilton, S. B., Graham, M. M., Knudtson, M. L., Lu, M., et al. (2020) · Health and Quality of Life Outcomes · doi:10.1186/s12955-020-01627-2 · Cited by 10
Gaemelke, T., Laustsen, C., Feys, P., Folkestad, L., Andersen, M., Jørgensen, N. R., Jørgensen, M.-L., Jespersen, S. N., Ringgaard, S., Eskildsen, S. F., et al. (2024) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2024.101279 · Cited by 8
“HADS was developed for use in medically ill patients and has later been validated in pwMS [114].”
MethodMeasuring the impact of systemic sclerosis on oral health‐related quality of life in a UK population
Abdouh, I. M., Porter, S. R., Fedele, S., Elgendy, N., Aboalshamat, K. T., Babkair, H. A., & Ríordáin, R. N. (2021) · Journal of Oral Pathology and Medicine · doi:10.1111/jop.13177 · Cited by 8
Miller, J., Altaras, C., Vissicchio, N. A., Zemon, V. M., Portnoy, J. G., Gromisch, E. S., Sloan, J., Tyry, T. M., & Foley, F. W. (2020) · Quality of Life Research · doi:10.1007/s11136-020-02567-6 · Cited by 8
Family Functioning and Multiple Sclerosis: Study Protocol of a Multicentric Italian Project
Tella, M. D., Perutelli, V., Miele, G., Lavorgna, L., Bonavita, S., Mercanti, S. F. D., Streito, L. M., Clerico, M., & Castelli, L. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.668010 · Cited by 10
“Particularly, the Hospital Anxiety and Depression Scale (HADS) will be employed to assess symptoms of anxiety and depression (Zigmond and Snaith, 1983; Costantini et al., 1999; Castelli et al., 2009; Honarmand and Feinstein, 2009).”
MethodFolke, F., & Melin, M. (2022) · Journal of Air Transport Management · doi:10.1016/j.jairtraman.2022.102254 · Cited by 9
Blair, M., Ferreria, G., Gill, S., King, R., Hanna, J. A., Deluca, D., Ekblad, A., Bowman, D., Rau, J., Smolewska, K., et al. (2017) · International journal of group psychotherapy · doi:10.1080/00207284.2016.1260457 · Cited by 4
“Fifty-nine patients expressed interest and were consequently screened with the Hospital Anxiety and Depression Scale (HADS) (Zigmond & Snaith, 1983), a validated measure of depressive and anxiety symptoms in persons with MS (Honarmand & Feinstein, 2009).”
MethodInfluentialDevelopment and initial validation of the Cognitive Change Scale (CCS)
Kever, A., Heuer, L. B., Simani, L., & Leavitt, V. M. (2024) · Multiple Sclerosis Journal · doi:10.1177/13524585241290102 · Cited by 7
Bazmi, E., Behnoush, A. H., Eskandarieh, S., Moghadasi, A. N., Navardi, S., Ayoubi, S., Behnoush, B., Forouzesh, M., & Sahraian, M. A. (2025) · Brain and Behavior · doi:10.1002/brb3.70458 · Cited by 7
“This was used to investigate the independent contribution of anxiety to SI in patients with MS and has been widely used for the measurement of anxiety in this population (Ellwardt et al. 2022; Giordano et al. 2011; Honarmand and Feinstein 2009).”
Aging and the neuropsychiatry of multiple sclerosis: a cross-sectional study
Freedman, D., Oh, J., Einstein, G., & Feinstein, A. (2025) · Journal of Neurology · doi:10.1007/s00415-025-13116-x · Cited by 9
“These patient-reported outcome measures were previously validated for use in MS [52–54].”
Self-citationWhat factors influence feeling competent as a parent with multiple sclerosis?
Uccelli, M. M., Ponzio, M., & Traversa, S. (2019) · Chronic Illness · doi:10.1177/1742395319895310 · Cited by 7
“The results from this study help to address a gap in our previous knowledge regarding efficacy and role satisfaction related to parenting with MS. Living with a chronic illness, particularly during relapses or when individuals experience distressing symptoms, could impact parenting and as a consequence the perception…”
BackgroundInfluentialKupjetz, M., Joisten, N., Rademacher, A., Gonzenbach, R. R., Bansi, J., & Zimmer, P. (2023) · BMC Neurology · doi:10.1186/s12883-023-03187-6 · Cited by 7
“In pwMS, the HADS is a sensitive and specific self-report measure that supports the detection of major depression, and/or generalized anxiety disorder [48].”
BackgroundStein, C., O’Keeffe, F. M., McManus, C., Tubridy, N. J., Gaughan, M., McGuigan, C., & Bramham, J. (2023) · Journal of Neuropsychology · doi:10.1111/jnp.12327 · Cited by 8
Silveira, S. L., Motl, R. W., Elmer, D. J., Botkin, T., Ontiveros, T., Williams, S., & Hubbard, E. A. (2024) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2024.105695 · Cited by 7
Predictors of Antidepressant Use Among People With Multiple Sclerosis
Freedman, D., Oh, J., & Feinstein, A. (2025) · Journal of Neuropsychiatry · doi:10.1176/appi.neuropsych.20240096 · Cited by 9
Self-citationA case-control study assessing parenting sense of competence in people with multiple sclerosis.
Uccelli, M. M., & Ponzio, M. (2018) · Rehabilitation Psychology · doi:10.1037/rep0000211 · Cited by 7
Panfilis, L. D., Veronese, S., Bruzzone, M., Cascioli, M., Gajofatto, A., Grasso, M. G., Kruger, P., Lugaresi, A., Manson, L., Montepietra, S., et al. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-052012 · Cited by 7
Vitamin D and Depressive Symptoms in Adults with Multiple Sclerosis: A Scoping Review
Concerto, C., Rodolico, A., Ciancio, A., Messina, C., Natale, A., Mineo, L., Battaglia, F., & Aguglia, E. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19010199 · Cited by 8
“Therefore, if a high evidence output might answer our scoping review question, their findings are not easily generalizable to patients with depression and MS in comorbidity [54].”
Podda, J., Uccelli, M. M., Tacchino, A., Pedullà, L., Bragadin, M. M., Battaglia, M. A., Brichetto, G., & Ponzio, M. (2022) · International Journal of MS Care · doi:10.7224/1537-2073.2021-101 · Cited by 7
Huynh, T. L. T., Silveira, S. L., Jeng, B., & Motl, R. W. (2022) · Rehabilitation Psychology · doi:10.1037/rep0000454 · Cited by 7
Kuendig, S., Kool, J., Polhemus, A. M., Schallert, W., Bansi, J., & Gonzenbach, R. R. (2022) · PLoS ONE · doi:10.1371/journal.pone.0274348 · Cited by 7
“Scores between 0 and 7 on HADS are interpreted as “normal”, while scores�8 points indicate depression in PwMS [30, 31].”
BackgroundFragkiadaki, E., Anagnostopoulos, F., & Triliva, S. (2023) · Counselling and Psychotherapy Research · doi:10.1002/capr.12615 · Cited by 9
Outcome measures for multiple sclerosis
Osborne, L. A., Noble, J. G., Maramba, I. D. C., Jones, K. H., Middleton, R., Lyons, R. A., Ford, D. V., & Reed, P. (2013) · Physical Therapy Reviews · doi:10.1179/1743288x13y.0000000094 · Cited by 7
Sex differences in predictors of illness intrusiveness in persons with multiple sclerosis
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Gromisch, E. S., Neto, L. O., Sloan, J., Tyry, T. M., & Foley, F. W. (2021) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2021.103079 · Cited by 7
Pakenham, K. I. (2012) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780199733989.013.0012 · Cited by 7
Ovacık, U., Tarakçı, E., & Özdemir, Z. (2023) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2023.104944 · Cited by 6
Christodoulou, V. N., Varvarousis, D., Ntritsos, G., Dimopoulos, D., Γιαννακέας, Ν., Vasileiadis, G. I., Korompilias, A. V., & Ploumis, A. (2024) · Disability and Rehabilitation · doi:10.1080/09638288.2024.2338197 · Cited by 6
“…Well-Being Schedule [48] (specifically, the 17 th Visual Analogue Scale (VAS) question)(GWBS q.17), the Hospital Anxiety & Depression Scale (HADS) [49], the Hamilton Rating Scale for Depression [50] (HRSD), the Modified Fatigue Impact Scale [51] (the Psychosocial part)(MFIS-Psychosocial), the…”
Fleming, K. M., Coote, S. B., & Herring, M. P. (2020) · Mental health and physical activity · doi:10.1016/j.mhpa.2020.100341 · Cited by 6
Meek, C., Moghaddam, N. G., Evangelou, N., Oates, L. L., Topcu, G., Allen, C. M., & das Nair, R. (2021) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2021.07.001 · Cited by 9
Mind wandering in people with Multiple Sclerosis: A psychometric study
Podda, J., Tacchino, A., Pedullà, L., Bragadin, M. M., Battaglia, M. A., Brichetto, G., & Ponzio, M. (2022) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2022.103521 · Cited by 7
Murphy, H. M., Fetter, C. M., Snow, N. J., Chaves, A. R. D. A., Downer, M. B., & Ploughman, M. (2023) · Multiple Sclerosis Journal - Experimental Translational and Clinical · doi:10.1177/20552173221143398 · Cited by 7
“10 www.sagepub.com/msjetc those with non-neuropathic pain have corticospinal hypoexcitability.37,51 The literature shows that most persons with MS experience pain from multiple sources, both neuropathic and non-neuropathic.5,8,49 Participants here may therefore have suffered predominantly from non-neuropathic pain,37,…”
BackgroundMethodInfluentialFatigue in multiple sclerosis is a diagnostic challenge: A cross-sectional study
Hosseini, S., Yazdchi, M., Sahraian, M. A., Majidi, S., Taher, S., Hassannezhad, S., & Mosaddeghi-Heris, R. (2022) · Journal of Research in Clinical Medicine · doi:10.34172/jrcm.2022.023 · Cited by 7
Jones, C. D., Kidwell-Chandler, A. L., Cederberg, K. L. J., Sikes, E. M., & Motl, R. W. (2023) · Disability and Rehabilitation · doi:10.1080/09638288.2023.2225876 · Cited by 6
“…into subgroups of non-elevated or elevated depression symptom scores based on a cut-point for the haDs (i.e., 8+ as indicative of elevated depressive symptoms) in persons with Ms [34,35]. the scale has evidence of score reliability and validity in measuring depression in persons with Ms [33,36].”
BackgroundFarber, A. E., Menascu, S., & Kalron, A. (2024) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2024.111675 · Cited by 6
Self-reported maximum walking distance in persons with MS may affect the EDSS
Berger, W., Payne, M. W. C., & Morrow, S. A. (2017) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2017.05.035 · Cited by 6
Heugten, C. M. V., Köhler, S., Francke, M., & Bol, Y. (2019) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2019.101392 · Cited by 6
Gromisch, E. S., Kerns, R. D., & Beauvais, J. E. (2019) · Rehabilitation Psychology · doi:10.1037/rep0000273 · Cited by 7
Marrie, R. A., Lix, L. M., Bolton, J. M., Fisk, J. D., Fitzgerald, K. C., Graff, L. A., Hitchon, C. A., Kowalec, K., Marriott, J. J., Patten, S. B., et al. (2023) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2023.111415 · Cited by 5
Hajji, E. B., Traoré, B., Hassoune, S., Khoubila, A., Bellakhdar, S., Rafai, M. A., & Lakhdar, A. (2024) · Epilepsia Open · doi:10.1002/epi4.12958 · Cited by 4
Nicola, M., Nicola, M., Zarif, B., Ghalid, A. E., Abdelrahim, M. E. A., & Hadidi, S. E. (2024) · Future Journal of Pharmaceutical Sciences · doi:10.1186/s43094-024-00738-7 · Cited by 6
Wallin, A., Franzén, E., Ekman, U., Piehl, F., & Johansson, S. (2023) · Pilot and Feasibility Studies · doi:10.1186/s40814-023-01265-7 · Cited by 5
“Assessment of primary and secondary outcomes Mini-BESTesta Feasible 10-meter walk testa 2-minute walk testa APDMb Gait analysis (spatial and temporal gait parameters) APDMb Sway test Six Spot Step Testa Multiple Sclerosis Walking Scalea Falls Efficacy Scale Internationala Frenchay Activities Index Multiple Sclerosis I…”
BackgroundUse of cannabis in patients with multiple sclerosis from Argentina
Contentti, E. C., López, P. A., Criniti, J. M., Pettinicchi, J. P., Tavolini, D., Mainella, C., Tizio, S., Tkachuk, V. A., Silva, B. A., Caride, A., et al. (2021) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2021.102932 · Cited by 5
Brouchet, M., Teng, M., Chesnel, C., Lagnau, P., Amarenco, G., & Hentzen, C. (2023) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2023.104950 · Cited by 5
Patel, V., & Feinstein, A. (2017) · Cognitive and Behavioral Neurology · doi:10.1097/wnn.0000000000000138 · Cited by 5
“A single MS study has done so too, but only in passing; those authors concluded that removing the item required setting a different threshold score for determining the presence of depression (Honarmand and Feinstein, 2009).”
BackgroundMethodInfluentialSelf-citationNeven, A., Janssens, D., Wets, G., Beirlant, K., Willekens, B. M. P., Asch, P. V., Vanlimbergen, P., & Feys, P. (2018) · Journal of Transport & Health · doi:10.1016/j.jth.2018.10.006 · Cited by 5
Posterior Fossa Lesion Load and Pathological Laughing and Crying in Multiple Sclerosis.
Luhoway, J., Sharma, M., Menon, S., Rosehart, H., & Morrow, S. (2019) · International Journal of MS Care · doi:10.7224/1537-2073.2018-016 · Cited by 6
Correlates of the personality change judgments of individuals who have MS
Weddell, R., & Fisher-Hicks, S. (2021) · Brain Injury · doi:10.1080/02699052.2020.1865568 · Cited by 5
“44) in a consecutive series of MS clinic attendees (38); a cutoff score of ≥8 indicates the presence of generalized anxiety disorder.”
BackgroundContentti, E. C., López, P. A., Pettinicchi, J. P., Tkachuk, V. A., Balbuena, M. E., & Caride, A. (2021) · Work · doi:10.3233/wor-213446 · Cited by 5
“Both depression (HADS-D) and anxiety (HADS-A) were assessed by the HADS [20].”
Hughes, A. J., Botanov, Y., & Beier, M. (2022) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2021.103481 · Cited by 5
Jones, C. D., Jeng, B., Šilić, P., & Motl, R. W. (2022) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2022.103889 · Cited by 5
The multiple sclerosis self-concept change scale: Development and validation of a new measure
Emery, H., van der Mei, I. A. F., Padgett, C. R., Ownsworth, T., Burke, T. V., Giles, L., & Honan, C. A. (2023) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2023.104955 · Cited by 6
Saul, A., Taylor, B. V., Blizzard, L., Simpson, S., Oddy, W. H., Shivappa, N., Hébert, J., Black, L. J., Ponsonby, A., Broadley, S., et al. (2024) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2024.105468 · Cited by 5
Silva, M. D. M. E., Mercer, P. B. S., Witt, M. C. Z., Pessoa, R. R., Viveiros, C. P., Gazola, B. B., de Oliveira, D. H., & Ianisky, R. (2018) · Jornal Brasileiro de Psiquiatria · doi:10.1590/0047-2085000000213 · Cited by 37
O'Keeffe, F., Cogley, C., McManus, C., Davenport, L., O'Connor, S., Tubridy, N., Gaughan, M., McGuigan, C., & Bramham, J. (2024) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2024.105719 · Cited by 4
Which type of PROMs to use in MS routine clinical care: The validity of PROMIS CAT questionnaires
Beckerman, H., Eijssen, I. C. J. M., Walraven, R., Strijbis, E. M. M., Terwee, C. B., Uitdehaag, B. M. J., de Groot, V., & de Jong, B. A. (2025) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2025.106320 · Cited by 4
Body image, sexual dysfunction and psychological distress in people with multiple sclerosis
Breheny, E., O’Keeffe, F. M., & Cooney, S. M. (2025) · Disability and Rehabilitation · doi:10.1080/09638288.2025.2527959 · Cited by 4
“…and anxiety were measured using the hospital anxiety and Depression scale (haDs) [33]. anxiety and depression symptoms were considered clinically significant in the current study where participants scored ≥8 [34]. health-related quality of life was assessed with the short Form-36 (sF-36) [35].”
Factors influencing employment and absenteeism in working age people with multiple sclerosis
Iron, A., Menascu, S., & Kalron, A. (2025) · Scientific Reports · doi:10.1038/s41598-025-20165-9 · Cited by 5
“Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS), widely used in clinical practice and validated in the pwMS population 24 .”
Stevens, N., Ezegbe, C., Ngwa, V. F., Makowiecki, K., Zarghami, A., Nguyen, P. T., Sansom, J., Smith, K., Laslett, L. L., Denham, M., et al. (2024) · Trials · doi:10.1186/s13063-024-08425-x · Cited by 5
“– Anxiety and depression, using the Hospital Anxiety and Depression Scale (HADS) [22, 23].”
MethodInfluentialJallouli, S., Ghroubi, S., Bouattour, N., Sakka, S., Damak, M., Mhiri, C., Yahia, A., Elleuch, M. H., de Marco, G., Driss, T., et al. (2025) · Journal of Dietary Supplements · doi:10.1080/19390211.2024.2449030 · Cited by 5
“Depression and anxiety were assessed by the Hospital Anxiety and Depression Scale (HADS) that is a validated questionnaire for the mood disorders evaluation in PwMS (Honarmand and Feinstein 2009).”
Boccia, V. D., Leveraro, E., Cipriano, E., Lapucci, C., Sirito, T., Cellerino, M., Rebella, G., Nasone, L., Boffa, G., & Inglese, M. (2025) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2024-335144 · Cited by 5
Longitudinal Study of Cognitive Phenotypes in Patients with Relapsing–Remitting Multiple Sclerosis
Sousa, C., França, M., Jacques, T., Sá, M. J., & Alves, R. A. (2025) · Archives of Clinical Neuropsychology · doi:10.1093/arclin/acaf004 · Cited by 4
Jerković, A., Safić, I. S., Pavelin, S., Pleić, N., Glavor, K. D., Vujović, I., Šoda, J., Duranović, J., & Vidaković, M. R. (2025) · Brain Sciences · doi:10.3390/brainsci15101122 · Cited by 4
“Honarmand and Feinstein [43] found that a cut-off score of eight or greater on either subscale provides high sensitivity and specificity for detecting major depression and generalized anxiety disorder, confirming the scale’s utility as a screening tool in this population.”
Moumdjian, L., Six, J., Veldkamp, R., Geys, J., Linden, C. V. D., Goetschalckx, M., Nieuwenhoven, J. V., Bosmans, I., Leman, M., & Feys, P. (2022) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.14777 · Cited by 4
Critch, A. L., Snow, N. J., Alcock, L. R., Chaves, A. R. D. A., Buragadda, S., & Ploughman, M. (2023) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2023.104514 · Cited by 4
Sousa, C., Jacques, T., França, M., Campos, P., Sá, M. J., & Alves, R. A. (2024) · The Clinical Neuropsychologist · doi:10.1080/13854046.2024.2348831 · Cited by 6
“The hADS is widely used in clinical practice and has been validated in the MS population (da Silva et al., 2011; honarmand & Feinstein, 2009).”
Depressies bij multiple sclerose
Arts, N. J. M. (2013) · Tijdschrift voor Neuropsychiatrie en Gedragsneurologie · doi:10.1007/s40533-013-0003-9 · Cited by 4
Depression and Multiple Sclerosis: Clinical Aspects, Epidemiology, and Management
Théaudin, M., & Feinstein, A. (2015) · Neuropsychiatric symptoms of neurological disease · doi:10.1007/978-3-319-18464-7_2 · Cited by 4
Self-citationPerceived and Objective Attentional Deficits in Multiple Sclerosis
Pöttgen, J., Stephan, J., Gold, S. M., Heesen, C., & Penner, I. (2015) · Zeitschrift für Neuropsychologie · doi:10.1024/1016-264x/a000153 · Cited by 4
A new way of rapidly screening for depression in multiple sclerosis using Emotional Thermometers
Thompson, A. G. B., Sheldon, R., Poole, N. A., Varela, R., White, S., Jones, P., Mulley, C., Berg, A., Blain, C. R. V., & Agrawal, N. (2019) · Acta Neuropsychiatrica · doi:10.1017/neu.2019.1 · Cited by 4
“HADS We used the version as originally published by Zigmond and Snaith (18) and previously validated in an MS patient population, by Honarmand and Feinstein (19).”
BackgroundMethod
Metadata
- Authors
- Honarmand, K., & Feinstein, A.
- Affiliations
- Sunnybrook Health Science Centre (CA)
- Venue
- Multiple Sclerosis Journal
- Publisher
- SAGE Publications
- Published
- 2009-11-13
- Volume
- 15
- Issue
- 12
- Pages
- 1518-1524
- ISSN
- 1352-4585 (ISSN-L)
- 1477-0970
- OpenAlex
- W2114728329
- Cited by
- 436
- References
- 43
- Citations by year
- 2026: 23 · 2025: 32 · 2024: 36 · 2023: 31 · 2022: 34 · 2021: 43 · 2020: 23 · 2019: 27 · 2018: 34 · 2017: 26 · 2016: 32 · 2015: 26 · 2014: 23 · 2013: 12 · 2012: 15
- FWCI
- 14.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Multiple Sclerosis Journal (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Multiple Sclerosis Society
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Clinical Neurology › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- Hospital Anxiety and Depression Scale, multiple sclerosis, depression, anxiety disorders, generalized anxiety disorder, psychometric validation, cut-off values, sensitivity and specificity, self-report scale
- MeSH terms
- Adolescent, Adult, Aged, Anxiety Disorders, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Multiple Sclerosis, Predictive Value of Tests, Psychiatric Status Rating Scales, Surveys and Questionnaires, ROC Curve, Sensitivity and Specificity, Severity of Illness Index, Reproducibility of Results, Logistic Models, Young Adult
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